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The Ohio attorney general filed a lawsuit on Monday accusing three large pharmacy benefit managers of fixing prices for various medicines, the latest effort to scrutinize the controversial companies that occupy a crucial role in pharmaceutical pricing.

The lawsuit alleges Humana, Prime Therapeutics, and Cigna — which owns Express Scripts — shared pricing information and other data gathered by a company based in Switzerland to gain an upper hand in negotiations with drug companies for rebates on insulins and other drugs, including generics. The company was created as subsidiary of Express Scripts, which gave Prime a minority stake in 2019, the suit stated, although it was initially billed as a collaboration.

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The company, Ascent Health Services, has been described as a group purchasing organization, which typically negotiates prices for prescription drugs on behalf of members. In this case, however, Ohio Attorney General Dave Yost alleges that Ascent served other pharmacy benefit managers and acted as a clearinghouse in which the companies could access each other’s pricing information.

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